Why the study?
DOACs are the preferred choice for anticoagulation in AF, but drug interactions can compromise their efficacy and safety.
Does the co-prescription of interacting medications with DOACs increase the risk of adverse events in patients with atrial fibrillation?
Does the co-prescription of interacting medications with DOACs increase the risk of adverse events in patients with atrial fibrillation?
Careful management and personalized dosing of DOACs in AF patients are essential to mitigate the significant bleeding risks associated with drug-drug interactions, particularly with CYP3A4 and P-glycoprotein modulators.
Introduction: Atrial fibrillation (AF) is a common cardiac arrhythmia that elevates the risk of thromboembolic events, necessitating effective anticoagulation strategies. Direct oral anticoagulants (DOACs) have become the preferred choice due to their safety profiles; however, drug interactions can compromise their efficacy and safety. Objective: This study aims to assess the impact of drug interactions on the efficacy and safety of DOACs in patients with AF. Method: A literature review was conducted using databases such as the Virtual Health Library, LILACS Plus, and Medline, focusing on articles published from 2019 to 2024. Inclusion criteria emphasized studies related to drug interactions involving DOACs and AF, resulting in the selection of 13 relevant articles. Results: The analysis revealed a significant prevalence of drug interactions among patients treated with DOACs. Co-prescription with CYP3A4 inhibitors and P-glycoprotein modulators was linked to increased bleeding risks. Factors such as age, renal function, and the presence of comorbidities were crucial in determining appropriate dosing and the risk of adverse events. Conclusion: Careful management of AF patients on DOACs is vital to mitigate risks associated with drug interactions. Personalized treatment approaches that consider individual clinical profiles and ongoing education for healthcare providers are essential to optimize anticoagulation therapy.
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Lee et al. (2024) conducted a review in Atrial Fibrillation. Direct oral anticoagulants (DOACs) with interacting drugs (e.g., CYP3A4 inhibitors, P-glycoprotein modulators) vs. DOACs without interacting drugs was evaluated on Efficacy and safety (bleeding risks).
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